Tamara J. Somers, PhD, of the Duke University Medical Center in Durham, NC, and colleagues conducted a cross-sectional study involving patients with SLE to determine how self-efficacy for pain control and pain catastrophizing are related to SLE symptoms that are resistant to medical therapy, such as pain, stiffness, fatigue, and psychological distress.

After controlling for age, race, and disease activity, the researchers found that lower self-efficacy for pain control was associated with much higher levels of fatigue, pain, and stiffness. A lower positive mood was reported by patients with higher levels of pain catastrophizing. Standard assessments of SLE disease activity performed by rheumatologists did not correlate with patients' physical symptoms, psychological distress, self-efficacy for pain control, or pain catastrophizing.

"Results suggest that pain coping cognitions (eg, either self-efficacy for pain control or pain catastrophizing) are significantly related to physical symptoms and psychological distress in patients with SLE," the authors write. "This finding is important because work from other samples of patients with persistent pain conditions has shown these pain coping variables can be modified using psychological interventions and that such treatment-related changes in pain cognitions are related to improved outcomes."